Provider Demographics
NPI:1013291152
Name:CHIARELLO, THOMAS ANTHONY
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ANTHONY
Last Name:CHIARELLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 TERRACE RD
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29642-2830
Mailing Address - Country:US
Mailing Address - Phone:864-787-0596
Mailing Address - Fax:
Practice Address - Street 1:1622 E NORTH ST
Practice Address - Street 2:SUITE #9
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-1329
Practice Address - Country:US
Practice Address - Phone:864-242-2267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-07
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHAS 0491237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist